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Ireland's pay rates are not pushing more nurses, midwives and doctors to work abroad - report

The report said that there were issues around recruiting consultants with certain specialities in specific areas.

A REPORT INTO the problems faced by those who work in Ireland’s healthcare system has found that “pay rates do not appear to be unduly affecting the number of nurses, midwives and doctors applying to work abroad”.

The report, compiled by the Public Service Pay Commission, said that although there wasn’t a major issue with recruitment and retention among nurses and midwives, that there is a difficulty in recruiting consultants with certain specialities in certain locations across the country.

It said that the challenges for staff in the healthcare sector were “multi-faceted”, but not limited to pay rates.

“The Commission is not persuaded, based on the evidence available, that current pay arrangements are, in themselves, a significant impediment to recruitment.

Indeed the Commission remains of the view, expressed in its first report, that remuneration is not the main issue impacting on the recruitment and retention where difficulties exist.

However, the Commission’s report did make several recommendations related to pay:

  • Location Allowances currently paid to nurses in 13 service areas in the health service should be increased by 20% and extended to cover maternity services
  • Specialist Qualification Allowance currently paid to nurses and midwives who acquire post graduate qualifications should be increased by 20%
  • Staff nurses and midwives should be eligible to attain the grade of senior staff nurse/midwife after 17 rather than the current 20 years post qualification.

A recruiter who represents Irish nurses in Australia had said that the rate of progression in Australia or the UK was far quicker than in Ireland, which was attractive to nurses who wished to progress up the ranks.

Nurses and midwives

The Commission said that there were 5,494 first preference applications for 1,830 nursing and midwifery undergraduate places in 2018.

It said that although the level of staff turnover decreased slightly between 2016 and 2017, that the “evidence examined by the Commission indicates continuing difficulties in retaining nurses and midwives in specific areas”.

The Commission found that the average earning for all HSE staff nurses and midwives (excluding all promotional grades) in 2017 was approximately €51,000 including allowances overtime and other payments.


The report said that there has been an increase in consultant numbers of 33% from 2007 to 2017.

In 2017 consultant turnover rates based on HSE data were 7.8% (or 6.6% excluding retirements), this is a reduction of 1.1% compared to the 2016 turnover rate. By comparison with other sectors, this rate of turnover is low.

It added, however that recruitment was still an issue.

The Commission concludes that there is a general difficulty in recruiting consultants with more significant problems in certain specialities and geographic locations.

 The average earnings for consultants in 2017 was almost €180,000, including overtime and other payments.

Budget 2019

The government is in the process of preparing for the Budget announcement in October, after which talks about extending the confidence and supply agreement with Fianna Fáil will resume.

It’s looking like there won’t be massive giveaways in this year’s budget, as figures published by the Department of Finance show that the government collected €32.4 billion in tax this year to date – an increase on the same period last year, but less than what had been projected.

It’s stifled talk that there would be large gains to be made in the form of giveaways, and raised concerns that the current government arrangement won’t last long beyond the Budget – threatening the call of a general election.


The strongest statement against today’s report came from the Irish Nurses and Midwives Organisation.

The organisation’s general secretary Phil Ní Sheaghdha said that “nursing and midwifery are professions in crisis, with only one application for every four vacancies.

Talk to nurses and midwives anywhere in Ireland, and they’ll tell you pay is the number one cause of understaffing. 
Ireland simply can’t hire enough nurses and midwives on these wages.”

The President of the Irish Medical Organisation (IMO), Dr Peadar Gilligan, said that there was a very real crisis in recruitment and retention of Doctors in Ireland and that government policy must change if we are to stop the haemorrhaging of doctors from the Irish system.

Speaking today, Dr Gilligan said; “The IMO Council will meet later this week to discuss this report in detail following which a detailed response to the report will be sent to the Commission.

There are almost 500 vacant consultant posts at present and more NCHDs are emigrating to work and live abroad than ever before.

“The challenge now is for the government to devise a realistic response to this crisis which will address the critical shortage of doctors now and in the years ahead.”

The Irish Hospital Consultants Association (IHCA) has said that it welcomes the confirmation in the Public Service Pay Commission Report of the significant crisis in the recruitment and retention of hospital consultants.

The President of the Association, Dr Donal O’Hanlon, said that the “crisis needs to be urgently addressed in order to provide timely and quality care to patients and to resolve the difficulties arising from the failure to fill a significant proportion of consultant posts.

The IHCA will be pressing that a resolution of the crisis is immediately put in place given the large number of vacant public hospital posts throughout the acute hospital system.

“The extreme level of salary discrimination against new entrant consultants is the root cause of the crisis and must be ended without delay.”

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